The Great Cholesterol Myth (37 page)

Amino acids
—molecules that link together to form proteins.

Angina
—chest pain or discomfort produced when the heart doesn’t get enough blood.

Anthocyanins
—compounds found in plants, especially berries, that have powerful antioxidant properties. Anthocyanins provide the pigments responsible for the rich colors of berries.

Arteriosclerosis
—general term for any kind of hardening or stiffening of the arteries.

Artery
—a blood vessel that carries blood away from the heart.

Astaxanthin
—a powerful antioxidant found primarily in wild salmon and krill. It’s responsible for salmon’s pink-red color.

Atherogenic
—capable of producing plaque in the arteries.

Atherosclerosis
—a condition in which the arteries thicken, the walls become inflamed, material builds up, and plaque is formed. Commonly referred to as “hardening of the arteries.”

Atom
—the smallest component of an element having the chemical properties of the element.

Beta blocker
—a class of drugs used for various indications such as cardiac arrhythmias and hypertension. It diminishes the effects of stress hormones such as adrenaline.

Bifurcation
—to separate into two parts or branches, as when the main stem of a blood vessel divides to become two smaller vessels.

Bile acids
—a complex fluid found in the bile of mammals that aids in fat absorption. Bile acids are produced from cholesterol in the liver and stored in the gallbladder.

Blood clot (also known as a thrombus)
—blood clots form when there is damage to the lining of a blood vessel. Normal clotting is an important mechanism in helping the body repair injured blood vessels. When unneeded blood clots form, however, this can have potentially serious consequences.

Blood pressure
—the pressure exerted against the walls of the blood vessels by circulating blood.

Calcification (as in the arteries)
—the process by which calcium builds up in soft tissue, including arteries and heart valves, causing it to harden.

Carbohydrates
—one of the three “macronutrients” or classes of food (the others are protein and fat). Carbohydrates include sugars and starch.

Cardiac ischemia (also known as myocardial ischemia)
—a decrease in blood flow that reduces your heart’s oxygen supply. It can damage your heart muscle.

Cholesterol (includes serum cholesterol)
—a waxy sterol that is an essential component of cell membranes. (A sterol is a particular type of fat.) It’s the principal sterol synthesized by animals and is important for the manufacture of sex hormones, vitamin D, and bile acids.

Coenzyme Q
₁₀
(CoQ
₁₀
)
—a vitamin-like substance found in every cell in the body; essential for the manufacture of the body’s energy molecule, ATP; a powerful antioxidant; approved since 1974 in Japan, where it is used for heart failure. It is significantly depleted by statin drugs.

Conjugated linoleic acid (CLA)
—a “good” trans fat found in the meat and milk of grass-fed animals. Much research has shown that it has anticancer properties and may also help with body composition (reduction in body fat).

Control group
—a group in a scientific experiment that is treated identically to the experimental group in every way except that it’s not given the drug or treatment being tested. In drug tests, the control group gets a placebo. The effects of the drug or treatment are measured in the experimental group, which is then compared to the control group.

Cortisol
—a steroid hormone produced by the adrenal gland. It is the primary “stress hormone” in the body

COX-2 inhibitors
—a class of compounds (often drugs) that inhibit enzymes in the body called COX (cyclooxygenase). COX-1 maintains the normal lining of the stomach while COX-2 increases in response to inflammation. COX-2 inhibitors reduce inflammation while leaving COX-1 alone.

C-reactive protein
—protein in the blood used as a systemic measure of inflammation.

Cytokines
—inflammatory chemicals produced by a variety of cells in the body, including those in the adipose (fat) tissue.

D-alpha tocopherol
—one of eight forms of vitamin E.

Diabetes, type 1
—an autoimmune disease that results in the destruction of the insulin-producing cells in the pancreas. Type 1 diabetics don’t produce enough insulin, and the disease is typically fatal unless treated with exogenous insulin (either by injection, inhalation, or insulin pumps).

Diabetes, type 2
—a chronic condition in which the cells “ignore” insulin (see
insulin resistance
), usually resulting in dangerously high blood sugar and insulin levels. Ninety to 95 percent of diabetics have this type of diabetes, which is a lifestyle-related disease.

Diet–heart hypothesis
—the idea that saturated fat and dietary cholesterol cause or contribute to heart disease.

DL-alpha tocopherol
—a synthetic form of vitamin E.

Docosahexaenoic acid (DHA)
—an omega-3 fatty acid found primarily in fish. It is particularly important for the brain.

Dolichols
—important for the synthesis of glycoproteins, which in turn are important for emotions, cell identification, cell messaging, and immune defense. Statin drugs reduce them, because dolichols are produced by the same pathway that produces cholesterol and is interrupted by statin drugs. Reduced bioavailability of dolichols can affect every cellular process in the body.

Double-blind study
—a study in which neither the subjects nor the experimenters know which subjects are getting an active drug and which subjects are getting a placebo. Double-blind studies are believed to minimize the effect of experimenter and patient expectations.

D-ribose
—molecule made in the body’s cells and used for cellular function.

Eicosanoids
—mini hormones that control metabolic processes in the body; also called prostaglandins.

Eicosapentaenoic acid (EPA)
—an important omega-3 fatty acid found primarily in fish. It is particularly important for the heart.

Electrons
—tiny subatomic particles that carry a negative electric charge and surround the nuclei of atoms.

Ellagic acid
—a natural antioxidant found in many vegetables and fruits, particularly raspberries, strawberries, and pomegranates. It is being investigated for its anticancer properties.

Endocrinology
—the study of hormones and what they do.

Endothelial dysfunction (ED)
—dysfunction of the cells that line the inner surface of all blood vessels. A major feature of endothelial dysfunction is the inability of the arteries to dilate (open) fully. ED contributes to several diseases, including diabetes, and it is always associated with heart disease.

Endothelium
—the thin layer of cells that lines the inner surface of blood vessels.

Enzyme
—a complex protein that speeds the rate at which certain chemical processes take place.

Epinephrine (also known as adrenaline)
—an important stress hormone released by the adrenal glands.

Estrogen
—family of hormones that perform about four hundred functions in the human body; produced primarily in the ovaries and adrenal glands; known as the “female hormone” but present in both women and men.

Farnesyl-PP
—an intermediate in the HMG-CoA pathway.

Fat
—one of the three major classes of nutrients known as “macronutrients” (the others being protein and carbohydrates). It is made up of smaller units called fatty acids.

Fatty acids
—the building blocks of fat.

Fiber
—indigestible component of food; associated with lower risks of heart disease, diabetes, obesity, and cancer.

Fibrates
—a class of drugs used for lowering cholesterol. They also lower triglycerides.

Fibrin
—a protein essential for the clotting of blood.

Fibrinogen
—a protein that is converted to fibrin during the blood-clotting process.

Flavanols
—a group of plant pigments, including the anthocyanins, that are beneficial to health.

Flavonoids
—plant compounds that have antioxidant and anti-inflammatory activity.

Folic acid
—a water-soluble B vitamin needed for proper development of the human body and to help the body make healthy new cells. Folic acid is the synthetic (man-made) form of folate, found naturally in some foods.

Free radicals
—destructive molecules in the body; can harm cells and DNA by producing “oxidative damage.”

Fructose
—fruit sugar, found naturally in honey, berries, fruits, and most root vegetables. Table sugar is half glucose, half fructose. The most damaging of the sugars when taken in concentrated forms such as sugar, high-fructose corn syrup, or agave nectar. Causes insulin resistance, fatty liver, and elevated triglycerides.

Geranyl-PP
—a product of the condensation of dimethallyl-pp and isopentyl-pp.

Glucagon
—the “sister” hormone of insulin, made in the pancreas. Increases when blood sugar levels are low. Helps counteract the effects of insulin.

Glucocorticoids
—a class of steroid hormones produced by the adrenal glands. Cortisol is the most important glucocorticoid.

Glucose
—a simple sugar and component of most carbohydrates. Table sugar is 50 percent glucose. It is measured in the blood as blood glucose.

Glycation
—the result of the bonding of a protein molecule with a sugar molecule. It is also known as nonenzymatic glycosylation.

Glycemic Index
—measure of how much a portion, specifically 50g, of a given food raises blood sugar.

Hemochromatosis
—a disorder that results in too much iron being absorbed from the gastrointestinal tract.

High-density lipoprotein (HDL)
—a complex of lipids and proteins that transports cholesterol in the blood and is often thought of as the “good” cholesterol.

High-fructose corn syrup
—a sweetener made by processing corn syrup to increase the level of fructose.

HMG-CoA reductase
—an enzyme that plays a central role in the production of cholesterol in the liver.

Homeostasis
—derived from the Greek, meaning “remaining stable” or “remaining the same.” A relatively stable state of equilibrium.

Homocysteine
—an amino acid found in the blood, high levels of which increase the chance of heart disease, stroke, osteoporosis, and Alzheimer’s. Homocysteine can be lowered with folic acid, vitamin B
₆
, and vitamin B
₁₂
.

Hormones
—chemical messengers that travel in the bloodstream and affect sexual function, growth, development, mood, and many different metabolic processes.

Hydrogenated or partially hydrogenated oil
—the process of adding hydrogen to vegetable oil is called hydrogenation. It makes the oil less likely to spoil but also creates trans fat, the most damaging of all the fatty acids.

Hypertension
—high blood pressure.

Hyperviscosity
—increased thickness of the blood.

Inflammation, acute
—a tissue response to injury, usually of a sudden onset. Examples include injuries to the knee or back, abscesses, and skin outbreaks. Classical signs include pain, heat, redness, and swelling.

Inflammation, chronic
—prolonged and persistent inflammation that often flies beneath the pain radar. It is a critical component of nearly all degenerative diseases. Chronic, persistent inflammation of the vascular walls is a major cause of heart disease.

Insulin
—fat-storing hormone that, if raised high enough, long enough, and frequently enough, contributes to diabetes, heart disease, and aging.

Insulin resistance
—the condition in which the cells stop “listening” to insulin, resulting in high blood sugar and high insulin. Insulin resistance is associated with metabolic syndrome and type 2 diabetes.

Intermediate-density lipoprotein (IDL)
—one of five major groups of lipoproteins that transport different types of molecules, including cholesterol, through the bloodstream.

Isopentyl pyrophosphate (IPP)
—an intermediate in the HMG-CoA pathway.

Keys, Ancel
(1904–2004)—an American researcher and scientist whose Seven Countries Study appeared to show that serum cholesterol was strongly related to coronary heart disease. He persuaded many Americans—and mainstream health organizations—to adopt and endorse a low-fat diet.

L-carnitine
—a vitamin-like compound that escorts fatty acids into the mitochondria of the cells, where it can be “burned” for energy.

Left ventricular hypertrophy
—enlargement (hypertrophy) of the muscle tissue that makes up the wall of the heart’s main pumping chamber (the left ventricle).

Lipid core
—an important component of “vulnerable plaque” (plaque prone to rupture). Approximately 40 percent of vulnerable plaque is composed of the lipid core.

Lipid rafts
—regions of cell membranes that are involved in intracellular signaling pathways. They are particularly rich in cholesterol.